Selective effects of pioglitazone on insulin and androgen abnormalities in normo‐ and hyperinsulinaemic obese patients with polycystic ovary syndrome
Authors: Romualdi, D.; Guido, M.; Ciampelli, M.; Giuliani, M.; Leoni, F.; Perri, C.; Lanzone, A.
Source: Human Reproduction, Volume 18, Number 6, June 2003 , pp. 1210-1218(9)
Publisher: Oxford University Press
Abstract:BACKGROUND: To investigate the effectiveness and safety of pioglitazone (45 mg/day) on clinical and endocrine‐metabolic features of polycystic ovary syndrome (PCOS), we studied 18 obese PCOS patients, classified as normoinsulinaemic (N‐PCOS, n = 6) and hyperinsulinaemic (H‐PCOS, n = 12) according to their insulin secretion. METHODS: Evaluation of clinical signs, hormonal and lipid profile assays, oral glucose tolerance tests and euglycaemic hyperinsulinaemic clamps were performed at baseline and after 2 (visit 2), 4 (visit 3) and 6 (visit 4) months of treatment. RESULTS: Body weight, body fat distribution and blood pressure remained stable throughout the treatment; hirsutism and acne significantly improved (P < 0.001 for visits 3 and 4 versus baseline) in both groups. A restoration of menstrual cyclicity was observed at visit 4 in 83% (P < 0.001) of H‐PCOS and in 33% of N‐PCOS. A decrease in LH, LH/FSH ratio, androstenedione and 17‐hydroxy‐progesterone was observed in both groups, attaining statistical significance in H‐PCOS. A significant amelioration of insulin secretion, sensitivity and clearance was obtained in H‐PCOS. A trend towards improvement was observed in lipid assessment of both groups. Therapy was well‐tolerated. CONCLUSIONS: Present data suggest that there is a selective effect, partially independent of insulin secretion, of pioglitazone on the clinical and hormonal disturbances of PCOS.
Document Type: Research Article
Affiliations: Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Largo ‘A. Gemelli’ 8, 00168 Roma and
Publication date: June 2003
- Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. Papers published cover the scientific and medical aspects of reproductive physiology and pathology, endocrinology, andrology, gonad function, gametogenesis, fertilization, embryo development, implantation, pregnancy, genetics, genetic diagnosis, oncology, infectious disease, surgery, contraception, infertility treatment, psychology, ethics and social issues. The highest scientific and editorial standard is maintained throughout the journal along with a rapid rate of publication.